Chronic subdural hematoma is a common neurosurgical condition, particularly prevalent among the elderly population. Patients often require antithrombotic therapy, including antiplatelet agents and anticoagulants, due to underlying diseases or other factors. Antithrombotic drugs significantly influence the pathogenesis of chronic subdural hematoma, the effectiveness of surgical treatment, as well as the risk of recurrence and perioperative management. In recent years, there has been a growing body of research on the application of antithrombotic drugs in patients with chronic subdural hematoma; however, several challenges remain to be addressed, such as how to effectively weigh the risks posed by antithrombotic drugs against their therapeutic benefits. This article aims to review the impact of antithrombotic drugs on surgical complications, recurrence rates, and prognosis in patients with chronic subdural hematoma. By integrating the latest clinical studies and evidence-based medical data, we will explore reasonable management strategies for antithrombotic therapy to provide valuable references for clinical treatment.